ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Citywide Transmission of Multidrug-resistant Tuberculosis Under China's Rapid Urbanization: A Retrospective Population-based Genomic Spatial Epidemiological Study.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 62 papers.
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Who cites it
62 citing papers in PubMed.
- Quantifying the community transmission ofEmerging microbes & infections · 2026Article
- Long-term spatiotemporal evolution of drug-resistant Mycobacterium tuberculosis in China.Nature communications · 2026Article
- First insight of characteristics and prediction of Mycobacterium tuberculosis drug resistance by whole genome sequencing in Fujian Province, China.Scientific reports · 2026Article
- Molecular epidemiology of drug resistance and transmission ofMicrobiology spectrum · 2026Article
- Mutations in sugar metabolism-related genes driving global drug-resistant Mycobacterium tuberculosis transmission revealed by whole-genome sequencing.BMC infectious diseases · 2026Article
- Severe pre-treatment attrition in the care cascade: clinical outcomes and risk factors among older MDR/RR-TB patients in China.Frontiers in public health · 2026Article
- Impact of Drug-Resistant Tuberculosis Prevention and Control Strategies in Southeast China: Evidence from a Longitudinal Study on Disease Epidemic Trends and Predictions Across 15 Years.Infection and drug resistance · 2026Article
- Factors Influencing Adherence to All-Oral Short-Course Treatment for DR-TB and Establishment of a Predictive Model.Infection and drug resistance · 2026Article
- Transmission dynamics and attributable burden of tuberculosis among young and middle-aged adults in urban Shanghai: a genomic epidemiology study.Frontiers in public health · 2026Article
- Respiratory chain gene mutations associated with global phylogenetic clustering of drug-resistantFrontiers in immunology · 2026Article
- Extensive Endemic Transmission of Multidrug-ResistantOpen forum infectious diseases · 2026Article
- Whole genome sequencing to characterize the molecular epidemiology and drug-resistance of tuberculosis in Huzhou, China.BMC genomics · 2025Article
- Longitudinal phenotypic and genomic evidence revealing increased risk of drug resistance accumulation in tuberculosis patients in the counties of central China.Microbiology spectrum · 2025Article
- Integrating genomic and spatial analyses to describe tuberculosis transmission: a scoping review.The Lancet. Microbe · 2025Article
- Phylodynamic assessment of SNP distances from whole genome sequencing for determining Mycobacterium tuberculosis transmission.Scientific reports · 2025Article
- Transmission characteristics of tuberculosis in the high-TB-burden region of Southwest China.Frontiers in public health · 2025Article
- Genetic diversity and transmission pattern of multidrug-resistant tuberculosis based on whole-genome sequencing in Wuhan, China.Frontiers in public health · 2025Article
- Trends in Drug Resistance and Epidemiological Patterns of Tuberculosis in Elderly Patients in Wenzhou, China (2014-2023).Infection and drug resistance · 2025Article
- Type VII secretion system gene mutations driving global mycobacterium tuberculosis transmission revealed by whole genomic sequence.Frontiers in cellular and infection microbiology · 2025Article
- Cross-District Transmission of Tuberculosis in a High-Mobility City in China: Implications for Regional Collaboration in Infectious Disease Control.Infection and drug resistance · 2025Article
2 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors.
Funding
Abstract
backgroundPopulation movement could extend multidrug-resistant tuberculosis (MDR-TB) transmission and complicate its global prevalence. We sought to identify the high-risk populations and geographic sites of MDR-TB transmission in Shenzhen, the most common destination for internal migrants in China.
methodsWe performed a population-based, retrospective study in patients diagnosed with MDR-TB in Shenzhen during 2013-2017. By defining genomic clusters with a threshold of 12-single-nucleotide polymorphism distance based on whole-genome sequencing of their clinical strains, the clustering rate was calculated to evaluate the level of recent transmission. Risk factors were identified by multivariable logistic regression. To further delineate the epidemiological links, we invited the genomic-clustered patients to an in-depth social network investigation.
resultsIn total, 105 (25.2%) of the 417 enrolled patients with MDR-TB were grouped into 40 genome clusters, suggesting recent transmission of MDR strains. The adjusted risk for student to have a clustered strain was 4.05 (95% confidence interval, 1.06-17.0) times greater than other patients. The majority (70%, 28/40) of the genomic clusters involved patients who lived in different districts, with residences separated by an average of 8.76 kilometers. Other than household members, confirmed epidemiological links were also identified among classmates and workplace colleagues.
conclusionsThese findings demonstrate that local transmission of MDR-TB is a serious problem in Shenzhen. While most transmission occurred between people who lived distant from each other, there was clear evidence that transmission occurred in schools and workplaces, which should be included as targeted sites for active case finding.The average residential distance between genomic-clustered cases was more than 8 kilometers, while schools and workplaces, identified as sites of transmission in this study, deserve increased vigilance for targeted case finding of multidrug-resistant tuberculosis.
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